A new scoring system can be applied to predict the organ failure related events in acute pancreatitis accurately and rapidly.

ABSTRACT

AIM: To establish a new scoring system to predict the organ failure (OF)-related events in acute pancreatitis (AP) with high accuracy and rapidity. BACKGROUND: AP is a complicated immunological response that leads to multiple organ failure，but no single scoring system has so far effectively predicted the severity of OF-related events in AP. METHODS: The research utilized a retrospective study including 1076 AP patients to establish the new scoring system and a prospective study of another 138 patients to verify it. All the laboratory parameters were measured at admission (within 72 h of disease onset). Dunnett'T3 test, univariate and multivariate ordinal logistic regressions were performed. ROC curves were drawn to calculate the cut-off value of the chosen factors and to validate the predictive value of the system. RESULTS: Lactate dehydrogenase (LDH), creatinine (Cr), albumin (ALB) and calcium (Ca2+) made up the new system. The Area Under the Curve (AUC) of the system for OF was 0.904, and for persistent organ failure (POF) was 0.893 while that for death cases was 0.969. As a result, patients who scored 'zero' seemed to recover soon, who received a score '1-4' might have transient organ failure (TOF) but not POF. When the score was over 5, it was probable that patients would suffer POF, and even die if it exceeded 9. The test of the new scoring system proved it conducted well. CONCLUSION: The new scoring system can accurately and promptly predict the OF-related events in AP.